The purpose of this proposal is to renew funding for a program at Memorial Sloan-Kettering Cancer Center that develops outstanding head and neck surgeon/scientists; individuals both skilled in laboratory investigation and possessing advanced clinical understanding of head and neck cancer. Such individuals are needed to further inroads against cancers of the head and neck by translating basic science advances into clinical trials and new therapies. The efforts of the last generation of head and neck surgeons have defined the natural history, etiology, epidemiology, and the impact of therapy on head and neck cancers and cancer patients. Refinements in both extirpative and reconstructive techniques have been realized, and the applications of multimodality therapy are understood. Yet, despite advances in the experience, skills, and knowledge of head and neck surgeons, patient survival has improved only modestly. The last twenty years have produced an explosion of basic science knowledge in carcinogenesis and molecular biology of tumors. Knowledge of the control of the cell cycle, the functions of proto-oncogene and tumor suppressor genes, the mechanisms of signal transduction, and control of gene expression have revolutionized our understanding of tumor biology. The training and implementation of novel therapeutic strategies have naturally lagged behind these discoveries as clinicians learn to understand and act on new scientific findings. The challenge is then to be able to translate newly developed scientific knowledge into therapeutic strategies which prolong patient survival and improve quality of life. The development of surgeons with the skills to meet this challenge has been identified by the National Cancer Institute as a high priority. Our institution (through 9 years of T32 training grant funding) has successfully trained surgeons for leadership roles in academic institutions, where they are engaged in research and its applications to advance therapeutic strategies. Our program plan remains to provide an in-depth 18-24 month protected research experience as part of a 30 month Fellowship in Head and Neck Surgical Oncology. These postdoctoral candidates are recent graduates of otolaryngology, plastic surgery and surgery residency programs. Our current roster of 8 basic science mentors provides laboratory experiences for 2 senior level and one junior level recipient per year. These opportunities are available in all areas of cancer research including gene therapy and immunology, molecular cytogenetics and gene discovery, carcinogenesis and chemoprevention, molecular pathology, signal transduction, and tumor host interactions. Our 14 faculty consultants provide a consistent clinical input into the research project design and implementation, as well as excellent clinical training, instruction in the development of clinical protocols, biostatistics, substance abuse, quality of life assessment, courses on responsible conduct of research, and all aspects of cancer research. Memorial Sloan-Kettering Cancer Center provides a tremendous environment of excellent researchers, active broad education in cancer research, tremendous clinical volume and clinical training to train surgeons specialized in head and neck surgery, and head and neck cancer research. To date 100 percent of the seven senior level T32 grant awardees have graduated and achieved academic appointments in head and neck cancer programs at teaching institutions. They have published over 44 peer-reviewed articles and presented over 55 abstracts on their T32 supported research.